4 ms·
>There's a pretty huge asterisk to all that. Health insurers are adept at neatly sidestepping any obligations This might sidestep some obligations, rightly or
by lotsofpulp 9mo ago
>There's a pretty huge asterisk to all that. Health insurers are adept at neatly sidestepping any obligations
This might sidestep some obligations, rightly or wrongly. They clearly do not sidestep "any" obligations. The amount of money spent on healthcare claims (medical loss ratios) is public information, available in their SEC filings. It is required to be 80% or more by law.
https://www.oliverwyman.com/our-expertise/insights/2023/mar/health-insurer-financial-insights-volume-11-p1.html https://www.oliverwyman.com/our-expertise/insights/2023/mar/...
Every state government has an insurance regulator that also has to approve insurance prices, which are based on the cost of claims. The regulator is not going to let an insurer increase premiums just for profit.
Also, the non profit and for profit insurers have similar premiums, with the for profit insurers having ~3% profit margins or less, indicating a highly competitive market where the revenue is barely covering costs.
Shareholders aren't making any money either (10 year returns lag SP500):
https://totalrealreturns.com/s/CVS,ELV,UNH,MOH,VOO,CNC,HUM,CI?start=2015-01-02 https://totalrealreturns.com/s/CVS,ELV,UNH,MOH,VOO,CNC,HUM,C...
Finally, the fact that Buffett/Dimon/Bezos tapped out on creating a competitor should really drive home how little the profit potential is in health insurance, and any less "sidestepping" of obligations would lead to higher premiums.
https://www.cnbc.com/2021/01/04/haven-the-amazon-berkshire-jpmorgan-venture-to-disrupt-healthcare-is-disbanding-after-3-years.html https://www.cnbc.com/2021/01/04/haven-the-amazon-berkshire-j...
- FireBeyond 9mo ago> They clearly do not sidestep "any" obligations. I worked in EMS. United battled a bunch of civil suits years ago where they had denied HEMS transports (helicopter transport) from accident scenes due to "lacking pre-authorization". For a car accident. What would that even look like? "This is John, I'm a paramedic working on one of your patients who was hit by a truck. We would like to fly him to the trauma center due to extensive multisystem trauma but we need your authorization. His name? Hang on, let me find his wallet. No, that's Smythe, S-M-Y-T-H-E, sorry, I know, it's a bit loud with the jaws of life in the background... Uhh, sure, I guess I can hold for a nurse consult..."